ArticleThe American journal of clinical nutrition2011
Pre- and postfortification intake of folate and risk of colorectal cancer in a large prospective cohort study in the United States.
Article in The American journal of clinical nutrition, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 90 citations in OpenAlex.
- Pooled it
- Association between dietary factors and colorectal serrated polyps: a systematic review and meta-analysis.Frontiers in nutrition · 2023Pooled it
- Vitamin and multiple-vitamin supplement intake and incidence of colorectal cancer: a meta-analysis of cohort studies.Medical oncology (Northwood, London, England) · 2015Pooled it
- Folate deficiency modifies the risk of CIN3+ associated with DNA methylation levels: a nested case-control study from the ASCUS-COL trial.European journal of nutrition · 2024Trial
- The association between MTHFR 677C>T genotype and folate status and genomic and gene-specific DNA methylation in the colon of individuals without colorectal neoplasia.The American journal of clinical nutrition · 2013Trial
- Article
- Article
- Folate intake, tissue levels, and colorectal cancer deaths in a national cohort established before folic acid fortification.European journal of nutrition · 2025Article
- Biological, dietetic and pharmacological properties of vitamin BNPJ science of food · 2025Review
- Genetically predicted vitamins supplementation and risk of skin cancers: a Mendelian randomization study.Discover oncology · 2025Article
- Supplementation with Folic Acid or 5-Methyltetrahydrofolate and Prevention of Neural Tube Defects: An Evidence-Based Narrative Review.Nutrients · 2024Review
- Article
- The use of nutrigenomics and nutritional biomarkers with standard care of long-term recurrent metastatic rectal cancer: a case report.Frontiers in oncology · 2024Article
- Article
- Genome-wide interaction analysis of folate for colorectal cancer risk.The American journal of clinical nutrition · 2023Article
- Scientific opinion on the tolerable upper intake level for folate.EFSA journal. European Food Safety Authority · 2023Article
- Folate - a scoping review for Nordic Nutrition Recommendations 2023.Food & nutrition research · 2023Article
- Multivitamin Use and Overall and Site-Specific Cancer Risks in the National Institutes of Health-AARP Diet and Health Study.The Journal of nutrition · 2022Article
- MR1-dependence of unmetabolized folic acid side-effects.Frontiers in immunology · 2022Article
- Association of folate intake and colorectal cancer risk in the postfortification era in US women.The American journal of clinical nutrition · 2021Article
Corrections and comments
- Commented on by
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundA higher folate intake is associated with a decreased colorectal cancer risk in observational studies, but recent evidence suggests that excessive folate supplementation may increase colorectal cancer risk in some individuals. Therefore, mandatory folic acid fortification of grain products in the United States may have unintended negative consequences.
objectiveWe examined the association between folate intake and colorectal cancer risk, including 8.5 y of postfortification follow-up.
designWe examined the association between folate intake and colorectal cancer in the NIH-AARP Diet and Health Study-a US cohort study of 525,488 individuals aged 50-71 y initiated in 1995-1996. Dietary, supplemental, and total folate intakes were calculated for the pre- and postfortification periods (before and after 1 July 1997) based on a baseline food-frequency questionnaire. HRs and 95% CIs were calculated by using multivariable Cox proportional hazards regression models.
resultsDuring follow-up through 31 December 2006 (mean follow-up: 9.1 y), 7212 incident colorectal cancer cases were identified. In the postfortification analysis (6484 cases), a higher total folate intake was associated with a decreased colorectal cancer risk (HR for ≥900 compared with <200 μg/d: 0.70; 95% CI: 0.58, 0.84). The highest intakes specifically from supplements (HR: 0.82; 95% CI: 0.72, 0.92) or from diet (HR: 0.81; 95% CI: 0.67, 0.97) were also protective. The pattern of associations was similar for the prefortification period, and no significant differences between time periods were observed.
conclusionsIn this large prospective cohort study that included 8.5 y of postfortification follow-up, folate intake was associated with a decreased colorectal cancer risk. Given that the adenoma-carcinoma sequence may take ≥10 y, additional follow-up time is needed to fully examine the effect of folic acid fortification.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.